Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05901 | Date 23/07/2019 |
| Token No | SM/19-20/7109 23/07/2019 | Serial | 047 Last Visit: 09/08/2019 |
| Patient Name | Mrs. RASHIDA BIBI | Contact No | 6291234808 |
| Address | 12 CHATRA MUSALMAN PARA BYE LANE | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||